UNDERSTANDING WHO IMPROVES AFTER PSYCHIATRIC-HOSPITALIZATION

This study attempts to identify variables associated with improved fun ctioning after psychiatric hospitalization. The relationship between 2 5 clinical and demographic variables and improvements and functioning at discharge of 309 consecutive patients in an open ward over 2 years were studied using stepwise logistic regression. Measures of patient f unctioning at discharge were score above or below 50 on the (Global As sessment of Functioning scale) (GAF) and 3-point scale of functioning 1 week after discharge (needs constant supervision, functions independ ently at home, functions on the job). We created a logistic regression model of outcome based on the information available at admission and one based also on information at time of discharge (i.e., medication, therapy and length of stay etc.). Discharge models predicted 6-10% bet ter than admission models. Discharge models correctly predicted whethe r GAF level was above 50 in 72% of the cases and return to preadmissio n functioning in 71 % of the cases. We also created a model of functio ning at discharge using a hierarchical logistic regression model. It c orrectly predicted 74% of the lowest level of functioning, 47% of the middle level and 68% of the highest level. The best predictors of impr oved functioning after discharge were preadmission levels of functioni ng, psychotherapy in hospital, absence of organic brain syndrome, atte ndance at occupational therapy and hospitalization less than 4 months. Diagnosis had almost no discernible effect on outcome of hospitalizat ion.